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Mark Gabbay

Publications and source records attributed to Mark Gabbay.

6 recordsLinked to original sources
PubMed2006

The influence of GP and patient gender interaction on the duration of certified sickness absence.

BACKGROUND: Little research has focused upon how GP and patient gender interact to influence the outcome of consultation. In particular, no UK studies have investigated the effect of gender interaction on the duration of patients' certified sickness. OBJECTIVE: To investigate associations between the four GP-patient gender interaction categories and patient risk of intermediate or long-term work incapacity. METHODS DESIGN: Use of carbonized sickness certificates to collect routine sick note data over a 12-month collection period. SETTING: Nine general practices in the Mersey Primary Care R&D Consortium. SUBJECTS: A total of 3906 patients, certified sick by 67 GPs (including 45 GP principals). MAIN OUTCOME MEASURES: The effect of gender interaction was measured against two outcomes: intermediate (6-28 week) and long-term (28 weeks or over) periods of certified sickness. RESULTS: After univariate and multivariate analyses, it was discovered that certification of male patients by male GPs was significantly associated with increased prevalence of intermediate (6-28 week) certified sickness outcomes, compared with females certified by females (OR=1.38 P=0.009). This result was replicated in the subgroup of patients with mild mental disorder-related sickness absence. However, no association was demonstrated between gender interaction and long-term (>or=28 week) outcome, in the total patient group or within diagnostic subcategories. CONCLUSION: GP and patient gender appear to have most impact upon sickness certification in the intermediate period. This period is already recognized as the optimum time for interventions to prevent onset of long-term incapacity, particularly in cases where the cause of sickness absence is reversible (as in psychological-related certified sickness absence). Further research is needed (particularly focusing upon attitudes and content of consultations) in order to shed more light on the gender differences found in this study.

Adult↗
PubMed2004

When free condoms and spermicide are not enough: barriers and solutions to participant recruitment to community-based trials.

While randomised controlled trials remain the accepted 'gold standard' in medical research, participant recruitment is often problematic, particularly with primary care trials or those requiring healthy volunteers. Such difficulties can jeopardise the trial, leading to early abandonment, reduced statistical power or timetable and budget overruns. Substantial changes in recruitment plans may reduce the generalisability of the research. In order to overcome some of the more common recruitment difficulties, it is important that researchers share their recruitment strategy successes and failures. We report our experience of recruiting healthy volunteers to a condom trial, based within primary care and community populations. This was an RCT of the effect that using an additional spermicidal lubricant has on condom failure. We originally aimed to recruit entirely from Family Planning Clinics, but eventually required a wide variety of strategies. Targeted mailings, newspaper coverage and electronic 'posters' were among the most successful we used to bolster clinic recruitment. Concerned at our slow recruitment rates, we conducted a questionnaire survey investigating the reasons for participation and non-participation in the research completed by 101 trial participants, 112 decliners and 90 controls (total 303). The most important reasons given for taking part included 'considering the research to be important' (85%), 'wanting to help the researchers' (70%), 'having time to help' (62%) and 'getting free condoms and lubricant' (56%). The most popular reasons for declining were 'not wanting to use condoms' (38%), 'partner's unwillingness to take part' (29%), 'not wanting to alter usual contraceptive practice' (27%), 'not having time' (21%). Contrary to expectations, embarrassment and fears about confidentiality were relatively unimportant factors in this decision. In conclusion, the key to attaining recruitment targets was the core research team taking an active part, working closely with clinic staff and maintaining tight control of the process. Altruism remains a powerful motivation for participants, supported by incentives and procedural details to minimise personal inconvenience. Even for intimate research topics, these general factors outweigh specific issues.

Adult↗
PubMed2004

Depression in men attending a rural general practice: factors associated with prevalence of depressive symptoms and diagnosis.

BACKGROUND: Doctors are less likely to diagnose depression in men than in women. Little research has been conducted to explore the underlying reasons for this in rural settings, or to compare primary care doctors' and male patients' ratings of perceived depression. AIMS: To identify symptomatic and socio-demographic correlates of depression in men attending a rural practice, and to compare and contrast general practitioners' and patients' assessments of depression. METHOD: All male patients of working age attending a rural general practice over a 12-month period were invited to participate. RESULTS: Men reporting recent "chest pain" or "feeling tired/little energy", expressing low job enjoyment or with a previous diagnosis of depression were more likely to be scored above threshold on the Hospital Anxiety and Depression Scale-Depression sub-scale. There was little agreement between the doctors and their male patients about the degree of perceived depression. CONCLUSIONS: Educational interventions aimed at addressing the diagnosis of depression in men should take greater account of factors within a particular social setting.

Adult↗